Medicare Card Changes And
What You Need To Know

May 15, 2020

Recent high-level security breaches in the U.S. Voter Database, National Archives, and the Office of Personnel Management left more than 250 million Americans at risk of compromised data and identity theft. As hackers and identity thieves become more resourceful security can become more vulnerable, so government agencies are taking extraordinary precautions to protect our medical, financial, and personally identifiable information (PII) from those who would seek to compromise it.

The Centers for Medicare & Medicaid Services (CMS) is no different. Realizing its use of the social security number (SSN) as a member identifier could potentially put its more than 60 million enrollees at risk, CMS decided to update its patient identifiers to a more secure ID number to protect its customers and the medical providers who care for them.

Getting To Know The New Medicare Beneficiary Identifier (MBI)

By April 2019, all SSN-based Health Insurance Claim Numbers (HICN) will have been removed from Medicare cards and replaced by a new Medicare Beneficiary Identifier (MBI) that uses random numbers as the personal identifier. These precautions are all part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, and will be used for transactions like billing, eligibility, and claim status.

Medical and PII (social security numbers, birthdates, etc.) data are especially attractive to identity thieves, to include those who would use a patient’s card to take advantage of Medicare benefits. By replacing the SSN-based HICN with the MBI, CMS not only ensures that private health care and financial information will be protected, but also federal healthcare benefits and service payments are safe.

Transition Timeline

The roll-out of new cards began April 2018, with CMS phasing them in by geographical region. On December 31, 2019, the roll-out will have been complete. On January 1, 2020, all Medicare users should have their new cards in hand.

During the transition period between April 1, 2018 and December 31, 2019, CMS will monitor the use of HICNs and MBIs to see how many beneficiaries will be ready to use only MBIs by January 2020. They also will actively monitor the transition and adjustment to the new MBIs to ensure their wide-spread adoption so Medicare operations aren’t interrupted.

What Does This Mean For Medical Practices?

According to CMS, your office should be preparing now for the transition, even if your patients have not yet received their new cards. Proactive measures your office can take include:

Helping Your Patients Understand The Transition

It’s important that your patients – and office staff – understand that the MBI will have no effect on benefits or quality of care. Patient security and provider protection are goals that the HCIN cards could find hard to fulfill. In fact, the MBIs actually decrease your patients’ vulnerability to become victims of waste, fraud, theft, and abuse.

It seems so obvious, but explaining this to some patients – especially the elderly or concerned caregivers – may be problematic. It is important therefore to reiterate that these cards are CMS’s proactive approach to securing citizens’ identities and personal information, that the new MBI cards should be used immediately, and that the old HCIN cards must be destroyed as soon as the new cards are in hand.

Some Additional Thoughts

If your office doesn’t already have access to your Medicare Administrative Contractor’s (MAC) provider portal, you may want to sign up as early as possible so you can use the provider MBI look-up tool starting in June 2018.

Your staff may also want to participate in upcoming – or listen to previously recorded – CMS’s open-door virtual forums, presented through the Medicare Learning Network (MLN) Connects.

Finally, it is important for medical personal and staff to know that, while CMS will cease to use SSNs to identify Medicare beneficiaries, they will continue to use SSNs for Internal Revenue Service (IRS)-related activities, and the privacy and security of social security numbers is still as important as ever.

Navigating MACRA or any new Medicare initiative, rule, or regulation can be time-consuming and confusing. ProMD helps healthcare organizations maximize revenue while minimizing costly mistakes. No matter the size of your operation or the complexity of your billing, ProMD can improve your situation and benefit your customers.

If you have a medical practice, contact us at ProMD Practice Management to give your business an objective analysis. We have experienced medical practice management experts who can come and correct your practice’s errors so you can have a thriving practice again.

You can call us at 888-622-7498 or request a consultation online now. Let us help you get your practice to be working beautifully as it should be!

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